ABSTRACT

Herpes zoster (HZ) is a distressing, painful cutaneous eruption caused by reactivation of varicella-zoster virus (VZV), which stays latent in dorsal root ganglia after causing primary infection, varicella. It has been reported that HZ affects 20-30% of the individuals in the general population at some point in their lifetime and up to 50% of those are above 80 years old, since VZV-specific cell mediated immunity diminishes physiologically with the aging process. In fact, except post-herpetic neuralgia, HZ is a self-limited benign condition, which usually resolves without intervention unless the patient is immunosuppressed. On the other hand, in immunocompromised patients HZ may manifest with several clinical presentations and complications including disseminated HZ with visceral involvement, multidermatomal HZ, and treatment resistant HZ, also crusted, verrucous lesions, which are highly specific for especially human immunodeficiency virus-infected patients. Here, we want to present an otherwise healthy 30-year-old male patient, who had demonstrated an extensive large necrotic ulcer with an eschar-like crusting in a dermatomal distribution leading us to make a diagnosis of necrotic HZ.